a family in the making

Month: December 2014

[image]
It is New Year’s Eve, a time of new beginnings. Yet here I am, in the middle of a long, slow ending. As you know, my baby has died. There is no longer a heartbeat. On Monday, the ultrasound showed that the embryo had “deteriorated.” All signs point to goodbye, so long, see you on the other side. But my body won’t let go.

I’ve had no bleeding since last Wednesday night. As of Monday, my hcg was still rising and my progesterone was sky high.

On the one hand, I am grateful to my body for holding on. I’m grateful that it wants to fight for this. I truly am. Body, you are a rock star. But I also just want this part, the physical part, to be over.

There are three options when you have a miscarriage: wait for things to happen naturally, take a pill called Cytotec to induce contractions, or get a surgical procedure called a D & C or D & E. I had a D & C last time. It was completely fine — some cramping, some spotting, that’s it. This time, I am worried about about the risks of the procedure, which include scarring to the uterus. I really don’t need another thing hampering my fertility. And the miscarriage pill? No way, Jose. That scares me. I’ve read many horror stories, some of which say it’s like labor or the worst pain ever felt. I’ll save labor for live babies, thank you very much. And why, when I’m already in so much emotional pain, would I want to add excruciating physical pain to the mix?

So really, what I want is for this to happen naturally. But I also don’t want to wait forever. Carrying around a dead baby is, well, very sad. To this end, I’ve scheduled a D & C for Tuesday. Due to my hemming and hawing, and my clinic’s holiday schedule, they really couldn’t get me in any earlier. I am fine with that. It gives my body almost two weeks from finding out about the loss to do its thing. If there are no signs of letting go by then, I think I will just need to move on at that point.

My doctor has been on vacation since Christmas Eve. She returns on January 5th and we have an appointment to talk to her that day. I’ll ask her about the risks of the D & C then. If she seems concerned, I’ll suck it up and take the freaking Cytotec.

Fun fact: if I miscarry tomorrow, it will end up being a grand tour. Get pregnant on Thanksgiving, find out the baby is gone on Christmas and miscarry on New Year’s Day. A holiday trifecta, people! And yes, I am kind of laughing as I write this part, because it’s both funny and not funny at all.

While I wait for all of this to go down, I’ve been attempting to eat away my problems. I’ve thrown my no-gluten, no-dairy rule to the wind. I’d really like to be drinking my face off as well, but I’m still feeling nauseous, so alcohol isn’t really in the cards. After almost a week of this, I am, not shockingly, feeling physically awful, so it’s probably time to get back on the horse. Fiiiiine.

What do I long for this coming year?

Hope.

That’s it. I’ll keep it simple. I want this to be a year filled with hope.

And I do feel hope. Even now. Right in the center of my aching heart, I feel it. I now know that IVF can work for us. That’s huge. Sure, IVF contributed to the embryo implanting all askew this time, possibly causing the miscarriage. But that doesn’t mean it will happen like that the next time. Nothing is certain, which means anything is possible.

On Christmas Eve night I woke up with more bleeding. I had also developed some pain in my lower right side. I called the doctor’s office around 7 am on Christmas morning. We weren’t sure what to do. Should we start stockings and presents, knowing that the doctor might ask me to come in? They didn’t end up calling me back for an hour and a half, so we did start. What should have been an amazing Christmas morning with Lettie was tempered by the waiting and the pain in my side.

When they eventually called, they told me to come in. So we left Lettie with her grandparents and went. The whole time we were driving the 45 minutes to get there, I felt terrible for leaving her. Who on earth leaves their kid at Christmas? I looked out the window at the sunny sky and bare tree branches and felt like an asshole. I tried to talk to my embryo. Thump, thump, I thought at it, in an attempt to encourage a strong, beating heart.

The doctor’s office was a ghost town. There was one receptionist, one nurse and one doctor. The doctor did the ultrasound and said the blood clot had grown to twice its size. And the embryo no longer had a heartbeat. He looked for that heartbeat…and looked and looked. But it wasn’t there. The embryo had actually grown the right amount since the last ultrasound, but its heart had given up. The doctor was sorry, the nurse was sorry. Even the receptionist looked like she was about to cry. No one wants to give that news on Christmas morning.

The doctor said the baby might pass on its own or it might not. If I haven’t started bleeding before Monday, I’ll go back there and we can discuss a D & C. I haven’t had a bit of blood since Wednesday night, not even spotting. I’m still having every pregnancy symptom, including morning sickness. My body, it seems, is trying to hang onto this one. My mind understands — I don’t want to let it go, either.

Now I am faced with the fact that not only do I have trouble getting pregnant, but I also have trouble staying pregnant. The doctor is going to run the panel of tests for recurrent miscarriage. I am praying that we get some answers, but I also have to be realistic and accept that we might not. I can’t help but wonder if Lettie was just a miraculous fluke. Like, maybe the Universe was saying, “Ok, her mom is dying, so we’ll let this one baby slide through for her, just this once.” Trust me, I am grateful for that fluke every single day, but I’m starting to wonder if another one is just not meant to be.

So here I sit, entering yet another season of grief. There’s been a lot of that these last two and a half years — one mom and two babies. I feel like I know exactly what to expect now. There are those first few weeks of crushing sadness, of hiding in random bathrooms to cry in private. Then there are the months of feeling that you’re carrying a weight on your back because you just can’t shake the heartbreak. It might not be crushing anymore, but it is always there. Then, finally, acceptance and hope. So yeah, I know the drill. But I hate this fucking drill. I will go through it again, though, because I have no other choice.

Last night I woke up at 2 am. My underwear was soaked in bright red blood.

That’s it, I thought. I’m losing this baby. I stared at the ceiling all night. I took a shower. I cried.

This morning I called my doctor and went in for bloodwork and an ultrasound. The ultrasound revealed that the baby was still there, measuring on track for 6 weeks and 3 days. It was still situated off to the side. There was a heartbeat present, but it took her a minute to find it and I could barely see it. I remember my first ultrasound with Lettie at 6 weeks and 4 days — I saw a beautiful, strong beating heart immediately. I could see it very clearly. This looked different. It looked sluggish. My doc didn’t tell me how fast it was beating, but when I asked her if it looked slow she said yes, but that the heartbeat often starts out slow. It didn’t look great to me, but I am not a doctor.

The doctor told me she spotted a blood clot in the uterus and that’s what was causing the bleeding. She said I could expect more bleeding in the next few days.

The blood clot on its own does not spell certain doom, but she said that women who bleed in the first trimester are more likely to have a miscarriage. She said, “I’m not going to pretend I’m not concerned. I wish I could tell you what will happen either way, but I can’t. I’m sorry, but you’re going to have to wait it out and cross your fingers.”

So I guess we will see. I haven’t really had any more bleeding so far, but my abdomen is sore. I go back on Monday for another scan. My doctor will be on vacation and of course the dreaded Ovarian Overlord will be on duty that day. He’s probably the last person on earth I want to get bad news from, so hopefully there won’t be any.

This baby just keeps getting things stacked against it. I hope he or she is a fighter. But honestly, I am afraid to even hope anymore.

Thank you so much for all the thoughts/prayers/juju/rain dances earlier! I for real love you guys.

Everything looked good! The radiologist said something like, “The embryo is tucked up in there, but it looks fine. In this situation, they typically grow into the cavity rather than the uterine wall.” This basically reinforced what my doctor said on Monday. She also thinks my pain is from my enlarged ovaries and not anything pregnancy related.

During the ultrasound the radiologist kept telling the tech to stop because she thought she saw the heartbeat. And the tech kept being like, “No, that’s not it!” She was kind of sassy with the doctor. I could see Tim cracking behind them. They did this back-and-forth routine like five times, but they never officially saw it. She said in another week I should be able to see the heartbeat, which will line up nicely line with my appointment in six days. Fingers crossed!

My doctor called me about 20 minutes after I left to say that she got the report and the radiologist does not think it’s a cornual or interstitial pregnancy. They want to see me back at the hospital in two weeks for another scan. But for now, all is well.

I’m going to let myself relax now. I’ve been clenched up tight for four days solid. Like, epic anxiety levels. Eff that. I’m done (for now haha). This baby is going to make it. We’re going the distance. You hear that, little embryo?

Yesterday I started experiencing ovary pain, more on my left side than right. I emailed the nurses at my clinic to ask if that was weird (I didn’t think it was considering I’d recently pumped my ovaries full of drugs, but wanted to double check). They said that my doctor wanted me to come in for an ultrasound this morning. So I did. Everything looked the same. Baby was still off to the left. She pointed out the gestational sac, the yolk sac and then the embryo. I didn’t see a heartbeat, but I think at 5 weeks 5 days it’s probably still too early. Everything was measuring as it should be. My ovaries were large, but not filled with fluid. She said the pain was likely just my ovaries still being enlarged. But then she said that she wanted me to go to the hospital to get scanned with more high-tech equipment since the baby is eccentrically located. She said that she still doesn’t really think anything is wrong, but that she wants to be cautious and get a second opinion.

Woo boy. The hospital scan is today at 2:30. Ugh. I’m nervous. I could really use some good thoughts/vibes/prayers/juju around 2:30 today if you can spare it.

On top of this, Lettie was puking all night last night, and I have a cold and a UTI. So I’m just in general feeling exhausted and freaked out. Shit’s feeling ominous right about now.

Fingers crossed that whoever does the scan agrees with my doctor and sees nothing to worry about! Gulp.

I’ve learned some new information since yesterday, and I wanted to share it here in case I can help anyone else searching around for it. There’s not a lot out there currently.

I have two resident OB friends, and right before I posted yesterday, I emailed them to ask about my ultrasound. They obviously hadn’t seen the scan themselves, but both said, “It sounds like your doctor is concerned about an interstitial pregnancy.”

An interstitial, or cornual (these are actually two different things, but most people use them interchangeably), pregnancy is a rare type of ectopic pregnancy. The pregnancy implants in the uterus, but close or attached to the place where the fallopian tube connects with the uterus. It’s so rare that it represents 1-3% of all ectopic pregnancies. But apparently it’s more commonly seen with IVF. I’m not sure why. Unlike typical ectopics, beta numbers often rise normally.

Of course after hearing about this, I immediately emailed my doctor. She definitely did not mention interstitial pregnancy yesterday, so I wanted to hear what she had to say about the topic. Instead of emailing she called me back. Unfortunately, I missed the call.

Her voicemail was as follows:

“Hi, it’s Dr. G. I don’t think you need to worry. We obviously do need to keep an eye on it, but I think that this is not going to be an interstitial pregnancy.”

So that is very good, and I should just be reassured and go off into Happy Land, right? I know I should. But I have to be honest, you guys. I am really struggling. I don’t know if it’s the hormones or the stress of fertility treatments finally catching up with me, but I spent most of yesterday crying. Of course, it was stealth crying because I was at work. I’ve been doing all my usual visualizations and breathing and none of it is really working.

I can’t with the curve balls. They are so sneaky. I was worried about possibly not seeing a heartbeat at my six week ultrasound. I wasn’t really worried about the ultrasound yesterday. I certainly wasn’t worried about the rarest type of ectopic pregnancy. After all, my numbers were rising normally, so I thought I was in the clear there. Yet, it snuck in there, reminding me that there is no safety in this world, and there is no surefire way to protect your children, even when they’re in your own body.

I know I’m sounding dramatic here. I recognize that, but I just can’t shake it. Next ultrasound is a week from Wednesday, on Christmas Eve. I’m really hoping to get some good news then. Until then, I’ll be here, trying to get my peace back!

I had my first ultrasound early this morning. My doctor actually did end up doing the scan, which was nice. The pregnancy is definitely in the uterus. We saw a gestational sac and a yolk sac, which is all you can really see at this point. So that’s all good news.

But. And yes, there is a but, ugh. My doctor said the embryo had implanted “off to the left.” Ok, I was thinking this is no big deal. I mean, I’m sure an embryo doesn’t know that it needs to implant dead center, right? Then she went on to say that this meant that she’d “have to watch it” to see how it grows. When I asked her why, she said something about how the uterine wall is thinner there and, depending on how the embryo grows, there’s a chance the pregnancy could break through the uterus. Yeah, that’s not a terrifying image or anything. She didn’t seem too concerned about it, honestly. She said “in most cases, it’s fine.”

I, on the other hand, can’t stop thinking about it. Has anyone ever heard of this? I’m trying not to get too worked up, but I am scared.